novitas solutions medicare part (a, b)presents: webinar title€¦ · today’s presentation...

Texas Session

San Antonio, TX

March 22, 2019

Disclaimer

▪ All Current Procedural Terminology (CPT) only are copyright 2018 American Medical Association (AMA). All rights reserved. CPT is a registered trademark of the American Medical Association. Applicable Federal Acquisition Regulation/ Defense Federal Acquisition Regulation (FARS/DFARS) Restrictions Apply to Government Use. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

▪ The information enclosed was current at the time it was presented. Medicare policy changes frequently; links to the source documents have been provided within the document for your reference. This presentation was prepared as a tool to assist providers and is not intended to grant rights or impose obligations.

▪ Although every reasonable effort has been made to assure the accuracy of the information within these pages, the ultimate responsibility for the correct submission of claims and response to any remittance advice lies with the provider of services.

▪ Novitas Solutions employees, agents, and staff make no representation, warranty, or guarantee that this compilation of Medicare information is error-free and will bear no responsibility or liability for the results or consequences of the use of this guide.

▪ This presentation is a general summary that explains certain aspects of the Medicare program, but is not a legal document. The official Medicare program provisions are contained in the relevant laws, regulations, and rulings.

▪ Novitas Solutions does not permit videotaping or audio recording of training events.

Join Our Email List Today

▪ Stay current with Medicare by receiving emails twice a week

▪ Available email lists (not all-inclusive):

• Jurisdiction H

• Jurisdiction L

• Part B Electronic Billing

• Novitasphere Portal

• ABILITY| PC-ACE

• Medicare Remit Easy Print (MREP) Users

▪ JH Providers join using:

• http://www.novitas-solutions.com/webcenter/portal/MedicareJH/pagebyid?contentId=00007968

▪ JL Providers join using:

• http://www.novitas-solutions.com/webcenter/portal/MedicareJL/pagebyid?contentId=00007968

http://www.novitas-solutions.com/webcenter/portal/MedicareJH/pagebyid?contentId=00007968

http://www.novitas-solutions.com/webcenter/portal/MedicareJL/pagebyid?contentId=00007968

Today’s Presentation

▪ Agenda:

• 2019 Medicare Updates and Reminders

✓ RHC Reminders

✓ RHC Top Claim Submission Errors

• Utilizing the Novitasphere Portal

• Reminders and Educational Resources

▪ Objectives:

• Identify and understand the current 2019 Medicare updates

• Understand the benefits of the Novitasphere Portal

• Identify and utilize the educational resources and information

Acronym List 1

Acronym Definition

AIR All Inclusive Rate

BHI General Behavioral Health Integration

CCM Chronic Care Management

CMS Centers for Medicare & Medicaid Services

CNM Certified Nurse-Midwife

CoCM Psychiatric Collaborative Care Model

CPT Current Procedural Terminology

CWF Common Working Files

EIDM Enterprise Identity Management

EHR Electronic Health Records

ERA Electronic Remittance Advice

Acronym List 2

Acronym Definition

FAQ Frequently Asked Questions

HCPCS Healthcare Common Procedure Coding System

HETS HIPPA Eligibility Transaction System

HMO Health Maintenance Organization

IPPE Initial Preventive Physical Exam

IVR Interactive Voice Response

NP Nurse Practitioner

MBI Medicare Beneficiary Identifier

MLN Medicare Learning Network

QMB Qualified Medicare Beneficiary

PA Physicians Assistant

Acronym List 3

Acronym Definition

PPS Prospective Payment System

RA Remittance Advice

RHC Rural Health Clinic

RTP Return to Provider

SSA Social Security Administration

TCM Transitional Care Management

2019 Medicare Updates and Reminders

Update to the RHC PPS

▪ MM10989:

• Effective: January 1, 2019

• Implementation: January 7, 2019

▪ Key Points:

• RHC PPS base payment rate is $84.70

✓ 2019 base payment rate reflects a 1.5 percent increase

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/MM10989.pdf

Care Coordination Services and Payment for

Rural Health Clinics (RHCs)

▪ MM10175:



▪ Key Points:

• Payment for care coordination services in RHCs by establishing two new G codes for use by RHCs

:

✓ General Care Management HCPCS G0511:

➢ This code can only be billed once per month per beneficiary, and could not be billed if other care management

services are billed for the same time period

✓ Psychiatric CoCM HCPCS G0512:

➢ This code can only be billed once per month per beneficiary, and could not be billed if other care management

services are billed for the same time period

• RHC claims submitted using CPT 99490 for dates of service on or after January 1, 2018, will be

denied

Current Procedural Terminology (CPT) only copyright 2018 American Medical Association. All rights reserved.


General Care Management Requirements

(G0511)

▪ RHCs can bill new General Care Management when:

• Practitioner furnishes a comprehensive E/M, AWV, or IPPE:

✓ Within one year of commencing care management services

• Beneficiary Consent:

✓ Obtained during or after the initiating visit

✓ Prior to care coordination services by RHC practitioner or clinical staff:

➢ Written or verbal, must be documented in the medical record

▪ Eligible patients:

• Option A:

✓ Multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the

patient and place the patient at significant risk of death

• Option B:

✓ Any behavioral health or psychiatric condition treated by the RHC practitioner:

➢ Including substance use disorders:

» Clinical judgment of the RHC practitioner, warrants BHI services



(G0511) (cont.)

▪ Minimum of 20 minutes of care

▪ Can only be billed once per month/per patient and by only one physician

▪ RHCs cannot bill for CCM services for a beneficiary during the same service period as billing

any other care management (outside of the RHC AIR) for the same beneficiary

▪ Informing the patient that only one practitioner can furnish and be paid for the service during

a calendar month

▪ Comprehensive care plan is established implemented revised or monitored

▪ Beneficiary must be able to receive notification and consent

▪ Patients must be given a written or electronic care plan



(G0511) EHR

▪ Care plan must be a structured recording using EHR technology:

• Demographics

• Problems

• Medications/medication allergies

• Creation of a structured clinical summary record

• A full list of problems, medications and medication allergies in the EHR must inform the care plan, care

coordination and ongoing clinical care

▪ Access to care management services 24/7 that provides the beneficiary with a means to make

timely contact with health care practitioners

▪ Continuity of care with a designated practitioner or member of the care team with whom the

beneficiary is able to get successive routine appointments

▪ RHCs would continue to be required to meet the RHC Conditions of Participation and any

additional RHC payment requirements

▪ Coordinate with all health care providers:

• Documentation of communication Current Procedural Terminology (CPT) only copyright 2018 American Medical Association. All rights reserved.

General Care Management Comprehensive Care

Management

▪ Eligibility requirements of Option B:

• Initial assessment or follow-up monitoring:

✓ Use of applicable validated rating scales

• Behavioral health care planning:

✓ Including revision for patients who are not progressing or whose status changes

• Facilitating and coordinating treatment:

✓ Psychotherapy, Pharmacotherapy, Counseling and/or Psychiatric consultation

• Continuity of care with a member of the care team

Psychiatric CoCM (G0512)

▪ RHCs can bill Psychiatric CoCM when:

• Practitioner furnishes a comprehensive E/M, AWV, or IPPE:

✓ Within one year of billing the CCM

• Beneficiary Consent:

✓ Obtained during or after the initiating visit

✓ Prior to care coordination services by RHC practitioner or clinical staff:

➢ Written or verbal, must be documented in the medical record

• First calendar month:

✓ Minimum of 70 minutes:

➢ Under direction of RHC practitioner

• Subsequent calendar months:

✓ Minimum of 60 minutes:

➢ By RHC practitioner and/or Behavioral Heath Care Manager (under general supervision)

▪ Can only be billed once per month/per patient and by only one physician

▪ RHCs cannot bill for CCM services for a beneficiary during the same service period as billing any other care management (outside of the RHC AIR) for the same beneficiary


Psychiatric CoCM (G0512) Requirements

▪ Eligible patients:

• Any behavioral health or psychiatric condition treated by the RHC practitioner:

✓ Including substance use disorders

✓ Clinical judgment of the RHC practitioner, warrants BHI services

▪ Required elements:

• Psychiatric CoCM requires a team that includes the following:

✓ RHC (physician, NP, PA, or CNM):

➢ Directs the behavioral health care manager or clinical staff

✓ Oversees the patients care:

➢ Prescribing medications

➢ Providing treatments for medical conditions

➢ Referrals to specialty care when needed

▪ Continues to oversee ongoing oversight, management, collaboration and reassessment


Psychiatric CoCM (G0512) Behavioral Health

Care Manager

▪ Behavioral Health Care Manager:

• Assessment and care management:

✓ Including the administration of validated rating scales

✓ Behavioral health care planning in relation to behavioral/psychiatric health problems:

➢ Including revision for patients who are not progressing or whose status changes

➢ Provision of brief psychosocial interventions ongoing collaboration with the RHC practitioner

➢ Maintenance of the registry

▪ Acting in consultation with the psychiatric consultant

▪ Available to provide services face-to-face with the beneficiary

▪ Continuous relationship with the patient

▪ Collaborative, integrated relationship with the rest of the care team

▪ Available to contact the patient outside of regular RHC hours as necessary to conduct the

behavioral health care manager’s duties


Psychiatric CoCM (G0512) Psychiatric

Consultant

▪ Psychiatric Consultant:

• Participates in regular reviews of the clinical status of patients receiving CoCM services

• Advises the RHC practitioner regarding diagnosis:

✓ Options for resolving issues with beneficiary adherence and tolerance of behavioral health treatment

• Making adjustments to behavioral health treatment for beneficiaries who are not progressing

• Managing any negative interactions between beneficiaries’ behavioral health and medical

treatments

• Facilitate referral for direct provision of psychiatric care when clinically indicated


Communication Technology Based Services and

Payment for RHC and FQHCs

▪ MM10843:



▪ Key Points:

• RHCs can receive payment for Virtual Communication services when:

✓ At least five minutes of communication technology based or remote evaluation services are furnished

➢ RHC practitioner

✓ Patient who has had an RHC billable visit within the previous year

➢ Medical discussion or remote evaluation is for a condition not related to an RHC service provided within the previous

seven days

➢ Medical discussion or remote evaluation does not lead to an RHC visit within the next 24 hours or at the soonest

available appointment

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM10843.pdf

Virtual Communication Billing

▪ Payment for virtual communication services in RHCs by establishing a new G code for use

by RHCs:

• Virtual Communication Services HCPCS G0071

▪ G0071 can be billed either alone or on the same claim as a billable visit:

• Virtual communication services are not billable if an RHC visit was furnished within the previous

seven days or the next 24 hours or soonest available appointment

▪ Coinsurance and deductibles apply

▪ Face-to-face billing requirement waived


Virtual Communication FAQs

▪ Question:

• What is the payment rate for the new code G0071 (Virtual Communication Services)?

▪ Answer:

• HCPCS code G0071 is set at the average of the national non-facility PFS payment rates for

HCPCS code G2012 (communication technology-based services) and HCPCS code G2010

(remote evaluation services) and is updated annually based on the PFS national non-facility

payment rate for these code

• For 2019, the payment amount for code G0071 will be $13.69 (average of HCPCS codes G2012

and G2010)


Additional Virtual Communication FAQs

▪ Question:

• Are there any limitations on the number of times HCPCS code G0071 (Virtual Communication

Services) can be billed for a single beneficiary?

▪ Answer:

• No frequency limitations at this time

▪ Question:

• Is beneficiary consent required before virtual communication services can be furnished?

▪ Answer:

• Beneficiary consent should be obtained before virtual communication services are furnished in

order to bill for the service

▪ Virtual Communication FAQs


https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/FQHCPPS/Downloads/VCS-FAQs.pdf

RHC Medicare Benefit Policy Manual Chapter

13 Updates

▪ MM11019:



▪ Key Points:

• Chapter 13 of the Medicare Benefit Policy Manual is being updated and revised for RHCs :

✓ RHC PPS Update

✓ Care Management in RHCs as finalized in the Calendar Year (CY) 2019 Physician Fee Schedule Final Rule

✓ Virtual Communication Services


Update to Mammography Editing

▪ CR 11132:

• Effective: July 1, 2019

• Implementation: July 1, 2019

▪ Key Points:

• Modifies existing editing for mammography to ensure that only the following revenue codes are billed on claims for screening and diagnostic mammography

▪ Type of Bill 12X, 13X, 22X, 23X or 85X:

• Screening mammography HCPCS 77067:

✓ 0403, 096X, 097X and 098X:

• Diagnostic mammography HCPCS 77065 and 77066:

✓ 0401, 096X, 097X and 098X

▪ Type of Bill 71X or 77X:

• Screening mammography HCPCS 77067:

✓ 0403 or 052X (professional component

• Diagnostic mammography HCPCS 77065 and 77066:

✓ 0403 or 052X (professional component)


https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2019Downloads/R4225CP.pdf

Update to Medicare Deductible, Coinsurance and

Premium Rates for 2019

▪ MM11025:

• Effective Date: January 1, 2019

• Implementation Date: January 7, 2019

▪ Key Points:

• 2019 Part A – Hospital Insurance:

✓ Deductible: $1,364.00

✓ Coinsurance:

➢ $341.00 a day for 61st-90th day

➢ $682.00 a day for 91st-150th day (lifetime reserve days)

➢ $170.50 a day for 21st-100th day (Skilled Nursing Facility coinsurance)

• 2019 Part B –Medical Insurance:

✓ Deductible: $185.00 a year

✓ Coinsurance: 20 percent

▪ Additional Reference:

• 2019 Medicare Parts A & B Premiums and Deductibles Fact Sheet


https://www.cms.gov/newsroom/fact-sheets/2019-medicare-parts-b-premiums-and-deductibles

New Medicare Card

▪ New Medicare card:o Health and Human Services

(HHS) logo

o Gender and signature line

removed

Important Dates For The New Medicare Card

Date Action

April 16, 2019 Statutory deadline for issuing new Medicare cards

January 2020Transition Period Ends: Must use the MBI on data exchanges

(some exceptions)

MBI Lookup

▪ Select the MBI Lookup from the left navigation bar

Select your NPI

from the drop

down box

Complete the “I’m not a robot”

verification once every 5 searches

MBI Inquiry Tab

New Medicare card with MBI not yet mailed

MBI Lookup Results

If the card containing the new

beneficiary’s MBI has been mailed,

you will be able to click on the MBI

Lookup Info tab to obtain the

patient’s new MBI number

RHC Reminders

Required Billing Updates for RHC

▪ MM9269:

• Effective April 1, 2016

• Implementation April 4, 2016

▪ Key Points:

• RHCs are required to report the appropriate HCPCS code for each service line along with the

revenue code and other codes as required

• Payment for RHCs will continue to be made under the AIR when all of the program requirements

are met


RHC HPCS Reporting Requirements and

Updates

▪ Special Edition Article SE1611

▪ Key Points:

• When a preventative service is the primary service for the visit, RHC’s should report modifier CG

on the revenue code 052x with the preventative health service

• Coinsurance and deductible are waived for the approved preventative health services

• Medicare will pay 100 percent of the AIR service

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/SE1611.pdf

Billing for Multiple Visits Same Day

▪ Multiple encounters on the same day constitute a single RHC visit, except for the following:

• The patient suffers an illness or injury that requires additional diagnosis or treatment on the same

day:

✓ The subsequent medical service should be billed using a valid HCPCS code, revenue code 052X, and

modifier 59:

➢ Modifier 59 signifies that the conditions being treated are unrelated and services are provided at separate times of

the day

• The patient has a medical visit and a mental health visit on the same day

• The patient has an IPPE and a separate medical and/or mental health visit on the same day:

✓ IPPE is a once in a lifetime benefit and should be billed using HCPCS code G0402 and revenue code

052X.


RHC Top Claim Submission Errors

Top Claim Submission Errors

JH Reason Codes JL Reason Codes

38200 U5233

U5233 38200

C7010 38031

32402 W7091

38031 32402

W7091 C7010

U5061 U5061

Reason Code 38200/38031

▪ Duplicate rejection:

• The newly submitted claim is a duplicate to a previously submitted outpatient claim

▪ Research:

• Verify claims history to determine if another claim was submitted for this date of service:

▪ Reason code action:

• If the posted claim is incorrect:

✓ Submit an adjustment correcting the information

Reason Code U5233

▪ RTP error:

• No Medicare payment can be made because the statement covered period falls within or overlaps

an enrollment period in a risk HMO

▪ Research:

• Verify the statement covered period

• Verify the patients eligibility


• Bill the claim to the beneficiaries HMO on file

Reason Code C7010

▪ RTP error:

• The edited outpatient claim has a from/through date that overlap a hospice election period

▪ Research:

• Verify the statement covered period:

✓ Hospice election period verified through Novitasphere, Fiscal Intermediary Shared System (FISS), HETS

or Interactive Voice Response (IVR)


• Related to the terminal illness:

✓ Bill the Hospice

• Unrelated to the terminal illness:

✓ Resubmit the claim to Medicare with the appropriate condition code 07

Reason Code 32402

▪ RTP error:

• Invalid revenue code for a HCPCS code reported or HCPCS is not valid for the date on which

services were provided

▪ Research:

• Verify the revenue code billed

• Verify the HCPCS code billed

• Verify the “from” and “through” dates


• Once revenue, HCPCS and/or from and through dates verified and corrected F9 claim for

processing

Reason Code W7091

▪ RTP error:

• Non RHC services

▪ Research:

• https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/bp102c13.pdf

section 60


• Bill Part B CMS 1500 claim form

https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/bp102c13.pdf

Reason Code U5061

▪ Rejection:

• Invalid Health Insurance Claim number, not found in the Common Working File crosswalk

▪ Research:

• Verify with the beneficiary for their valid Medicare number:

✓ Verify the Medicare number using, Novitasphere, Fiscal Intermediary Shared System (FISS), HIPPA

Eligibility Transaction System (HETS) or Interactive Voice Response (IVR)


• Resubmit claim with corrected Medicare number

Utilizing the Novitasphere Portal

What is Novitasphere?

▪ Free, secure web-based portal

▪ Part A – Access to Eligibility, Claim Submission with File Status, ERA,

Medical Review Record Submission, and Audit and Reimbursement

Cost Reports Submission

▪ Part B - Access to Eligibility, Claim Information and Remittance

Advice, Claim Submission with File Status, ERA, Claim Correction,

Secure Messaging and a Mailbox

▪ Live Chat feature

▪ Dedicated Help Desk- 1-855-880-8424

▪ For demonstrations and more information:

• JH Providers:

✓ http://www.novitas-solutions.com/webcenter/portal/Novitasphere_JH/

• JL Providers:

✓ http://www.novitas-solutions.com/webcenter/portal/Novitasphere_JL/

http://www.novitas-solutions.com/webcenter/portal/Novitasphere_JH/

http://www.novitas-solutions.com/webcenter/portal/Novitasphere_JL/

Enrollment Three Basic Steps

1. Complete the Novitasphere Portal Enrollment form

2. Register for Enterprise Identity Management (EIDM) User ID and

password

3. Register Novitasphere role in EIDM

Reminder: Keep your Novitasphere Access

Active

▪ Tips to maintain access:

• Set a recurring reminder on your calendar or phone

• Use the buddy system!

✓ Remind your colleagues to keep their access active, and ask them to remind you too

• Call for help:

✓ If you are having trouble successfully logging in, contact the Novitasphere Help Desk

✓ The Help Desk can assist with password issues, locked Multi-Factor Authentication (MFA) devices, and

adding additional MFA devices

• Sign up for the Novitasphere email lists:

✓ We don’t want to see you lose your access – so we issue monthly reminders

• Check your vacation schedule!

✓ Log in before leaving if you will be out of the office for an extended time

Novitasphere Feature List

Benefits & Eligibility

Benefits & Eligibility Results

Eligibility Information

▪ Eligibility

• Part A and B Eligibility Effective and Termination

Dates

• End Stage Renal Disease (ESRD) dates and

information

▪ Deductible

• Part B Total Deductible Remaining for Calendar

year

• Occupational, Physical and Speech Therapy

amounts applied to the capitation limits

• Rehabilitation Session counts

▪ Medicare Advantage Plan (MAP)

• Contract Name, Number, Address and Telephone

Number

• Plan number and Plan Name

• Type of Medicare Advantage Plan

• The Bill Option code of the Plan type

• Effective and Termination Dates

▪ Medicare Secondary Payer (MSP)

• The reason Medicare is secondary

• Effective and Termination Dates

• MSP Diagnosis Codes

• Name of Insurance Company and Address

▪ Hospice/Home Health

• Certification codes and dates

• Home Health Episode Start and End Dates

• Home Health Episode termination date

• Provider NPI Number of the Home Health Facility

▪ Preventive Services

• Number of Smoking Sessions remaining for the

Preventive Service Procedure Code

• Medicare Diabetes Prevention Program (MDPP)

usage

• Preventive Technical and Professional Dates

• Deductible Applied for the Calendar Year

• Deductible Remaining for the Calendar Year

• Coinsurance Remaining for the Calendar Year

▪ Inpatient

• Date of earliest and latest billing activity for the spell

of illness

• Hospital Information

• Skilled Nursing Facility Information

▪ QMB

• QMB Effective and Termination Dates

• QMB Deductible and Coinsurance Remaining

QMB Inpatient Spell, Hospital Information and SNF

Information

MBI Lookup

MBI Lookup Results

Benefits & Eligibility Results

Miscellaneous Documentation Submission

▪ Cost Report Reopening: • Used for Submission of reopening

Requests for a cost report after it has been settled

▪ Cost Report Appeals: • Used for the submission of supporting

documents for cost reposts that are under appeal

▪ SSI Realignment Request (DSH):• Used to request an update to a provider’s

disproportionate share statistics

▪ Provider-Based Determination: • Used to request initial setup or change in

a unit’s provider-based status

▪ Wage Index/Occupational Mix Submissions:

• Used to upload documentation for the yearly wage index and occupational mix audits

▪ Desk Review/Audit Additional Documentation:

• Used to upload documentation requested by the Novitas audit staff during the time of a desk review and/or audit

▪ Submit FOIA Request: • Used to submit a Freedom of

Information Act request for Medicare cost reports

▪ Submit PS&R Request:• Used to submit a Provider Statistical &

Reimbursement report request for fiscal years not covered on the CMS PS&R online system. Providers may utilize this selection if they are currently experiencing PS&R access issues as well

▪ General Correspondence: • Used to submit documentation for

items not covered in the above-mentioned table selections; such items include: ✓ Request for Interim Rate Change

✓ Request for Tentative Settlement Change

✓ TEFRA Exception Request

✓ SCH Low Volume Request

✓ Request for Change in Statistical Basis

✓ CMS Tie-In-Notice

✓ Bankruptcy

✓ Other Supporting Documentation

✓ 50%Reduction Request

CMS-838 Credit Balance Report

Reference

Self Service Tools

Contact Us

Novitasphere References

▪ Novitasphere Provider Portal Enrollment Overview Training Module:

• JH Providers:

✓ http://novitas-

solutions.com/cs/idcplg?IdcService=GET_FILE&RevisionSelectionMethod=L

atestReleased&dDocName=00082245&allowInterrupt=1

• JL Providers:

✓ http://novitas-

solutions.com/cs/idcplg?IdcService=GET_FILE&RevisionSelectionMethod=L

atestReleased&dDocName=00082245&allowInterrupt=1

▪ EIDM Registration Instructions:

• JH Providers:

✓ http://www.novitas-

solutions.com/webcenter/spaces/MedicareJH/page/pagebyid?contentId=000

24651

• JL Providers:


solutions.com/webcenter/portal/MedicareJL/pagebyid?contentId=00024651

http://novitas-solutions.com/cs/idcplg?IdcService=GET_FILE&RevisionSelectionMethod=LatestReleased&dDocName=00082245&allowInterrupt=1


http://www.novitas-solutions.com/webcenter/spaces/MedicareJH/page/pagebyid?contentId=00024651


Novitasphere References (Continued)

▪ Novitasphere Portal Enrollment Forms:

• JH 8292PJH:

✓ http://www.novitas-solutions.com/webcenter/spaces/MedicareJH/page/pagebyid?contentId=00081357

• JL 8292P:


solutions.com/cs/idcplg?IdcService=GET_FILE&RevisionSelectionMethod=LatestReleased&dDocName=0

0024645&allowInterrupt=1

• JH 8291PJH:

✓ http://novitas-



• JL 8291P:

✓ http://novitas-



http://www.novitas-solutions.com/webcenter/spaces/MedicareJH/page/pagebyid?contentId=00081357

http://www.novitas-solutions.com/cs/idcplg?IdcService=GET_FILE&RevisionSelectionMethod=LatestReleased&dDocName=00024645&allowInterrupt=1



Novitas News

New Novitas Learning Center

▪ Novitas strives to continually improve the services and resources provided to our

customers. Our most recent innovation is the redesign of the Novitas Learning

Center. Effective January 1, 2019, Novitas Learning Center users will observe a few

changes:

• The username previously established to access a Novitas Learning Center account will be replaced

by the user’s email address

• Existing users will log into their account using the email address associated with the user account

in the Novitas Learning Center

• All users will be prompted to reset their passwords after the January 1, 2019, transition:

✓ Users will only need to reset their password one time

• Historical learning information associated with the Novitas Learning Center account will be

migrated to the new system for all completed courses:

✓ If a course is still in progress at the time of the transition, it will not be moved to the new system

Trending Inquiries Received in the Customer

Contact Center

▪ Trouble using IVR to obtain beneficiary eligibility or claim status using an MBI ?

• When speaking an MBI in the IVR be sure to speak naturally, including normal pauses every few

characters

• Convert a MBI to a number that can be keyed into the IVR using the IVR Alphanumeric Conversion

Tool (JH) (JL):

✓ Example:

➢ MBI number EG-4TE-5MK-72 converted 1*32*414*81*325*61*5272

▪ Consider using the Novitasphere (JH) (JL) for most self service inquiries



http://www.novitas-solutions.com/webcenter/portal/Novitasphere_JH/Novitasphere

http://www.novitas-solutions.com/webcenter/portal/Novitasphere_JL/Novitasphere

Reminders and Educational Resources

Novitas Website

▪ http://www.novitas-solutions.com/webcenter/portal/MedicareJH/Medicare+JH+Home

▪ http://www.novitas-solutions.com/webcenter/portal/MedicareJL/Medicare_JL

http://www.novitas-solutions.com/webcenter/portal/MedicareJH/Medicare+JH+Home

http://www.novitas-solutions.com/webcenter/portal/MedicareJL/Medicare_JL

Website Satisfaction Surveys

Novitas Solutions eNews Mailing Schedule

▪ In response to your feedback, we are implementing a new delivery schedule for our “Novitas

Solutions eNews” email

▪ Our emails will arrive in your inbox just twice a week:

• Every Tuesday and Thursday

▪ These emails will still contain all the important Medicare news and updates you need

▪ We will continue to send any urgent Medicare news or alerts to your inbox instantly

▪ Join:

• JH Providers:

✓ http://www.novitas-solutions.com/webcenter/portal/MedicareJH/pagebyid?contentId=00007968

• JL Providers:

✓ http://www.novitas-solutions.com/webcenter/portal/MedicareJL/pagebyid?contentId=00007968



Customer Contact Information

▪ Providers are required to use the IVR unit to obtain:

• Claim Status

• Patient Eligibility

• Check/Earning

• Remittance inquiries

▪ Jurisdiction H:

• Customer Contact Center- 1-855-252-8782

• Provider Teletypewriter- 1-855-498-2447

▪ Jurisdiction L:

• Customer Contact Center- 1-877-235-8073

• Provider Teletypewriter- 1-877-235-8051

▪ Patient / Medicare Beneficiary:

• 1-800-MEDICARE (1-800-633-4227)

• http://www.medicare.gov

http://www.medicare.gov/

Summary

▪ Provided the latest news, updates, reminders and top claim submission errors

▪ Demonstrated the user-friendly functionality of the Novitasphere Portal

▪ Reviewed helpful Medicare reminders and education resources

Thank You

▪ Kim Robinson

Education Specialist, Provider Outreach and Education

[email protected]

442-400-7523

▪ Janice Mumma

Supervisor, Provider Outreach and Education

[email protected]

717-526-6406

▪ Stephanie Portzline

Manager, Provider Engagement

[email protected]

717-526-6317

mailto:[email protected]



novitas solutions medicare part (a, b)presents: webinar title€¦ · today’s presentation...

Documents